|Year : 2022 | Volume
| Issue : 3 | Page : 174-175
A Self-Made Bag-Assisted Laparoendoscopic Single-Site Surgery in Ovarian Teratomectomy during Pregnancy
Qing Li, Fang Fang, Chunhua Zhang
Department of Gynecology, the Huaian Maternity and Child Clinical College of Xuzhou Medical University, Huaian, Jiangsu, China
|Date of Submission||10-Feb-2022|
|Date of Decision||07-Apr-2022|
|Date of Acceptance||04-May-2022|
|Date of Web Publication||5-Aug-2022|
Dr. Chunhua Zhang
Department of Gynecology, Huai'an Maternity and Children Hospital, No. 104, Renmin South Road, Qingjiangpu District, Huaian, Jiangsu 223300
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Li Q, Fang F, Zhang C. A Self-Made Bag-Assisted Laparoendoscopic Single-Site Surgery in Ovarian Teratomectomy during Pregnancy. Gynecol Minim Invasive Ther 2022;11:174-5
|How to cite this URL:|
Li Q, Fang F, Zhang C. A Self-Made Bag-Assisted Laparoendoscopic Single-Site Surgery in Ovarian Teratomectomy during Pregnancy. Gynecol Minim Invasive Ther [serial online] 2022 [cited 2022 Aug 15];11:174-5. Available from: https://www.e-gmit.com/text.asp?2022/11/3/174/353424
| Objective|| |
The objective is to demonstrate stepwise self-made bag technique and surgical technique in managing ovarian dermoid cystectomy in pregnant patients through laparoendoscopic single-site surgery (LESS). The reported incidence of ovarian cysts in pregnancy varies from 0.05% to 1.2%; compared with open surgery, laparoscopic surgery adnexal cyst during pregnancy does not increase the risk to mother and fetus., In addition, LESS has better postoperative recovery. However, conventional laparoscopic surgery is safer than LESS.
| Design|| |
Stepwise demonstration of the technique with narrated video footage.
| Interventions|| |
The patient was a 31-year-old woman, gravida 3, para 2, at a gestational age of 15 weeks, who was diagnosed with 5.6 cm × 4.1 cm right ovarian teratoma and 2.0 cm × 2.3 cm left ovarian cyst. Ovarian teratomectomy was performed at the same time of the previous cesarean section in 2018. A self-made bag-assisted LESS approach to ovarian teratoma with several key strategies to minimize fetal impact, ovarian damage, and blood loss [Video 1]:
- Make a retrieval bag [Figure 1] before surgery with an inner packaging bag of the disposable suction tube
- Place the affected ovary in the retrieval bag and pull the bottom of the retrieval bag to the umbilicus to reduce the stimulation of the uterus by surgical procedures [Figure 2]
- Cut the surface of the affected ovary with a cold blade to reduce ovarian damage [Figure 3]
- Dissect the teratoma pedicle with an ultrasonic knife to reduce bleeding.
|Figure 2: Pull the bottom of the retrieval bag to the umbilicus to reduce the stimulation of the uterus|
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Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
| Conclusion|| |
When performing an ovarian cystectomy under LESS, we could use an upside down specimen bag to conveniently remove the cyst from the abdominal cavity with no spillage of toxic dermoid contents. A self-made specimen bag is cost-saving and convenient to use. The operation has the least impact on the pregnant uterus and avoids the impact on the fetus. Availability of a cold knife and hand suturing can maximize ovarian tissue preservation, leading to better protection of ovarian function.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ball E, Waters N, Cooper N, Talati C, Mallick R, Rabas S, et al.
Evidence-Based Guideline on Laparoscopy in Pregnancy: Commissioned by the British Society for Gynaecological Endoscopy (BSGE) endorsed by the Royal College of Obstetricians & Gynaecologists (RCOG). Facts Views Vis Obgyn 2019;11:5-25.
Cho HW, Cho GJ, Noh E, Hong JH, Kim M, Lee JK. Pregnancy outcomes following laparoscopic and open surgery in pelvis during pregnancy: A nationwide population-based study in Korea. J Korean Med Sci 2021;36:e192.
Lin Y, Liu M, Ye H, He J, Chen J. Laparoendoscopic single-site surgery compared with conventional laparoscopic surgery for benign ovarian masses: A systematic review and meta-analysis. BMJ Open 2020;10:e032331.
[Figure 1], [Figure 2], [Figure 3]